Individual
MISS JACQUELINE GRACE GIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
445 MAIN ST # 1128, CENTER MORICHES, NY 11934-3512
(631) 878-1043
Mailing address
445 MAIN ST BOX 1128, CENTER MORICHES, NY 11934
(631) 878-1043
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
23 012327
NY
Other
Enumeration date
12/24/2007
Last updated
12/24/2007
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